Choosing your HIF health cover. Visit us online or call to get a quote and join or switch today.

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1 Choosing your HIF health cover. Visit us online or call to get a quote and join or switch today.

2 What s Inside? Why choose HIF? 3 Your choice of Extras 4 SmartTeeth dental benefits 8 Choosing Hospital cover 12 Get a quote and join 16 Ways to pay and claim 19 SmartClaim for mobile 21 Hospital waiting period 22 2

3 Why it makes sense to choose HIF. We re guessing that choosing health insurance probably isn t high on your Things I really want to do with my spare time list. Frankly, it can be a bit of a chore. But it s important too. Who wants to be worrying about public hospital waiting lists or the cost of dental treatment when you or someone in your family needs health care? We re here to make choosing the right health insurance as quick, simple and painless as possible, starting with why it makes sense to choose HIF. 1. We re all about choice Unlike many other health funds, we don t dictate which healthcare providers you can use. With HIF you re free to visit YOUR preferred practitioner without being penalised financially. Choose the hospital, doctor or specialist you want, choose your dentist, chiropractor, optometrist, physiotherapist and more. You even have a great choice of easy ways to make a claim (see page 19). We keep things simple to make choosing the right cover easier. Speaking of easy, check out our online product selector at hif.com.au 2. Small premiums, BIG benefits We offer some of the most competitive and affordable private health insurance products in Australia. Our benefits are some of the best around, yet our average premium increases are consistently ranked among the lowest in the country. 3. You get low premiums because we re highly efficient We don t pay income tax or dividends to shareholders, we don t have a vast network of expensive branches and we don t spend massive amounts on advertising. Keeping our overheads down means we re able to keep your premiums down. 4. We ve got Australia covered We provide access to over 500 private hospitals across Australia. That means, if you re going to be away from home, or you plan to relocate, we ll still be there to help you during your time of need. A reassuring thought, isn t it? 5. We make switching easy If you want to switch to HIF, don t let the paperwork put you off. We ll take care of it all for you and we ll even honour the length of your membership with your previous fund, so (in most cases) you won t have to serve new waiting periods (see page 22 for more details). 6. No anonymous off-shore call centres When you call HIF, you re talking to a real HIF team member, right here in Australia a professional who works solely for you. Call us on and see for yourself. 7. Get your money back if you re not satisfied We know we have the best health cover in Australia, but if you decide within 30 days of taking our cover that it isn t right for you (and you haven t claimed), we ll give you a full refund of any premiums you have paid. To see even more reasons, visit hif.com.au Affordable Private Hospital and Extras Cover 3

4 Extras cover choices. Pick your own healthcare provider Unlike some health insurance funds in Australia, we believe in your right to choose your own healthcare providers. So while some health funds might restrict you to their contracted provider lists, we say you re free to seek treatment wherever you like, anywhere in Australia. With our very affordable Hospital and Extras cover options, the choice is yours. To find out more, visit hif.com.au or call us on

5 Your choice of Extras health cover. High quality, low cost Extras health cover Mention Extras health cover and people tend to glaze over. It can seem a bit dull. But it s not. Extras insurance is a wonderful thing, providing cover for your choice of everyday health services like dental, physiotherapy, optical, chiropractic, healthy lifestyle, ambulance, pharmacy and more. And, with some of the lowest premiums in Australia, our Extras options are great value for money too. What does our Extras cover include? Medicare s great, but it only goes so far. In fact, there are a whole bunch of everyday health care needs that aren t covered by Medicare. But fear not, our popular Extras options have you covered for all those services you re likely to need on a regular or even emergency basis. Choose from services such as: Dental Optical Chiropractic Physiotherapy Pharmacy Podiatry Complementary therapies Emergency ambulance And more... All you have to do is choose the most suitable level of Extras cover from our five options. Vital Options Need entry-level cover for those vital Extras services? Then choose Vital Options. With a straightforward 50% rebate for general dental, physio, chiro, osteo, emergency ambulance and some periodontal and endodontic services (up to an annual limit of $800), it s ideal if you re young singles and couples. Saver Options Want bigger rebates and a broader range of essential Extras services? No worries. Saver Options is great value ideal for younger people who want affordable cover for common services including (but certainly not limited to) general dental, optical, physio, chiro, pharmacy and emergency ambulance. Special Options If it s intermediate Extras you re after, we have just the product. Special Options includes major dental services, plus many other essential services like emergency ambulance, optical, chiro, physio, osteo, pharmacy, acupuncture, naturopathy and healthy lifestyle. Super Options Drum roll please... Introducing our most popular Extras option. Super Options has practically everything you could wish for major dental, chiro, physio, optical to name just a few, plus it covers a host of other services like orthoptics (eye therapy), podiatry consultations and speech therapy. Premium Options Here it is, the Extras option to top all Extras options. Premium Options has it all. It s the very definition of comprehensive, including all the services we mentioned for Super Options, plus larger rebates and higher annual limits. 5

6 Which Extras option is right for you? Use the comparison table below to help choose the extras cover that is right for you and your budget. Type of Service Vital * 50% Back Saver Special Super Premium Waiting Period Ambulance Urgent Auxiliary Home Nursing Asthmatic Spacers Chiropractic Complementary Therapies Dental General Unlimited Diabetes Education Dietetics Healthy Lifestyle Occupational Therapy Optical Orthoptics (Eye Therapy) Osteopathy Peak-flow Meter Pharmacy Drugs Physiotherapy Podiatry Consultations Speech Therapy Dental General Limited Blood Glucose / Pressure Monitor Dental Major Nebuliser / Humidifier Orthotic Appliances Psychological Consultations Assisted Reproduction Drugs Hearing Aids ^ ^ ^ Up to months 36 months Please note: For inclusions, benefits and annual limits, please refer to the separate PDS (Product Disclosure Statement). For items or services not listed in the above table, please contact us or refer to the separate PDS (Product Disclosure Statement) for coverage details. hif.com.au/pds * Some services are covered. * Up to a limit of $800 per person per calendar year. ^ Only applies to General dental: , 022, , , , , 926, Endodontic: Periodontal:

7 Ambulance cover. If you choose one of our popular Extras (other than Vital Options) options, you ll be automatically covered for urgent ambulance services (and a small $50 co-payment will apply for non-urgent ambulance). It makes financial sense too, especially when you consider the price of urgent ambulance transport costs over $900. In comparison, we think our Extras options are great value. For example, the annual cost for a single Saver Options policy is hundreds of dollars less than the average cost of ambulance assistance and means you ll be covered for 23 other commonly used services too (including general dental, optical, physio, chiro and pharmacy). Understanding ambulance cover arrangements across Australia Firstly it is important to understand that in the unfortunate event you require emergency ambulance transport, Medicare won t cover the cost. However, some state governments subsidise ambulance services, and some pensioners and low income earners may also be entitled to free ambulance assistance. For more information and to view the ambulance arrangements in your state or territory, visit hif.com.au Benefits paid: Emergency call-outs and transportation: 100% covered by HIF. Non-emergency call-outs and transportation: a $50 co-payment will apply. This does not apply to Vital Options, which pays 50% back on emergency ambulance only. Please see hif.com.au/vitaloptions for more details. Please note: Benefits are paid on charges raised for approved ambulance services. Benefits are not payable for inter-hospital transportation except for inter-hospital transfers relating to an emergency or new illness where approved on a case by case basis by HIF. Benefits are not payable for transportation from a hospital to your home, nursing home or other hospital, or for transportation for ongoing medical treatment. For more information, please refer to the separate Product Disclosure Statement (PDS) or visit hif.com.au/pds HIF Ambulance cover explained The great news about our ambulance cover is that it doesn t matter which level of Extras (other than Vital Options) cover you choose, the benefits for ambulance are exactly the same (and no limits apply either.) So if you do happen to need an ambulance in the future, you can rest assured that you ll be covered for 100% in most circumstances. The only time you ll be required to contribute is if the call out is considered non-urgent (or non-emergency ) in which case a $50 copayment will apply. 7

8 Smile, dental benefits are better with SmartTeeth. SmartTeeth is a unique benefits program that sets our private dental insurance cover apart. It s brilliant. And we can say that in all modesty because it was our members idea. They asked us for dental cover that rewards proactive dental care and provides higher rebates for the most popular services. So that s what SmartTeeth provides up to 100% rebate for the most popular dental services, like: Examinations Remineralisation Plaque and calculus removal Dentist-fitted sports mouthguards And it doesn t cost you a thing As a standard part our Saver, Special Super and Premium options (other than Vital Options), SmartTeeth provides added value, but at no added cost. Choose your own dentist Unlike some health funds, we don t have contracted dentists. With HIF, you re free to choose any dentist you want. In fact, the Australian Dental Association of Western Australia (ADAWA) has publicly commended our stance on protecting your right to choose. That makes us the only health insurance fund in Australia with an ADAWA commendation. Brush up on your dental care Check out our free online dental information resource our Healthy Advice Blog by Dr Emma. Focusing solely on dental health matters, it s written by a professional dentist who answers questions from our members. Visit hif.com.au How will my SmartTeeth dental rebate be calculated? We will pay a percentage of the dentist s fee, up to a set maximum benefit for each item of service^. For example, with our Premium Options Extras cover you get: 1 Top 24 general dental services: 80% to 100% of the fee, up to a set maximum benefit per item. 2 All other general dental services: 70% of the fee, up to a set maximum benefit per item*. 3 All other (i.e. major) dental services: 60% of the fee, up to a set maximum benefit per item*. Benefits differ for Vital Options. Please see hif.com.au/vitaloptions for more details. ^ Benefits may be limited where potential rebates exceed dental service sub limits or annual limit. * Contact us on for details of these services. 8

9 SmartTeeth: An example Mary is covered under Super Options and she visits her family dentist who completes Mary s first oral examination and her first plaque removal in the calendar year. As recommended by her dentist, Mary has a second (6 monthly) examination later that year. The following table is an example of the dentist s fee and the rebates Mary will attract. Maximum Dental Rebate Example Dental Item Description Dentist Fee Oral examination (first visit) Removal of calculus (first visit) Oral examination (second visit) Percentage of Fee Maximum Payable Rebate paid to Mary $ % $59.25 $55.00 $ % $ $ $ % $42.20* $42.20 * Figure represents 80% of the maximum rebate which is the maximum amount payable for subsequent visits. This does not apply to Vital Options. Please see hif.com.au/vitaloptions for more details. 9

10 Our top 24 SmartTeeth dental services Item Number 011 or or 114 or Description First visit Second visit Oral examination 100% 80% Removal of plaque, stain or calculus Topical application of remineralising agent 100% 80% 100% 80% 151 or 153 Provision of a mouthguard 100% 80% Please note: These benefits are payable on all our Extras products (other than Vital Options). The actual benefit amount cannot exceed our set maximum benefit for each dental item, service sub limits or annual dental limit. See the example on page 9 for more information. Item Number Description Premium Options Super Options Special Options Saver Options 013 Emergency oral examination 80% 70% 65% 65% 014 Consultation 80% 70% 65% 65% 022 Intraoral periapical or bitewing radiograph 80% 70% 65% 65% 118 Bleaching, external per tooth 80% 70% 65% 65% 161 Fissure sealing per tooth 80% 70% 65% 65% 311 Removal of permanent tooth 80% 70% 65% 65% Metallic restoration two surfaces direct Metallic restoration three surfaces direct Adhesive restoration one surface anterior Adhesive restoration two surfaces anterior Adhesive restoration three surfaces anterior Adhesive restoration one surface posterior Adhesive restoration two surfaces posterior Adhesive restoration three surfaces posterior 80% 70% 65% 65% 80% 70% 65% 65% 80% 70% 65% 65% 80% 70% 65% 65% 80% 70% 65% 65% 80% 70% 65% 65% 80% 70% 65% 65% 80% 70% 65% 65% 575 Pin retention per pin 80% 70% 65% 65% 577 Cusp capping per cusp 80% 70% 65% 65% Benefits differ for Vital Options. Please see hif.com.au/vitaloptions. 10 Please note: The actual benefit amount cannot exceed our set maximum benefit for each dental item, service sub limits or overall annual limit.

11 Award Winning Private Hospital cover options Quality private Hospital cover that is affordable for all Australians We know that choosing private hospital insurance cover can be confusing. Which fund should you choose? What level of cover? Will Hospital cover cut your tax bill? How easy is it to switch health funds? But relax. It s really not that complicated or expensive. Read on to see if private Hospital cover is for you and, if so, which option suits your needs. 11

12 Which hospital option is right for you? Nobody likes the idea of going into hospital. But if you or a member of your family has to, it s good to know you re able to: choose your preferred public or private hospital; choose the doctor or specialist you want; choose a private room, rather than a shared one; focus on getting better, safe in the knowledge you re covered for things like accommodation, in-patient services and theatre room fees. Simply choose the level of cover that suits your requirements there s an option for everyone. Recently arrived in Australia from overseas? If you have welcome! HIF has a range of products to suit the circumstances of all temporary or new residents of Australia. The products listed in this brochure are designed for permanent Australian residents only and cannot be used for private treatment by temporary residents; so if you re not a permanent resident of Australia and you are unsure of your options, visit hif.com.au to find out more about Overseas Visitors Health Cover or call us on GoldVital Basic hospital cover. Tick. No Medicare Levy Surcharge. Tick. GoldVital is our tax-saving, entry-level Hospital cover option of choice for young singles and couples who want cover for all the vital stuff, like treatment after an accident^ including related intensive care and theatre fees, plus other essential services, including surgery to remove tonsils, adenoids, appendix and wisdom teeth. GoldStarter Like GoldVital, our GoldStarter cover is a smart choice if you re younger and less likely to require things like maternity services or cardio (heart) procedures. But with GoldStarter you get a broader range of great-value cover that includes more nonemergency services and benefits. All the essentials, plus a bit more peace of mind. GoldSaver GoldSaver is our intermediate Hospital cover and is a step up from GoldStarter. It s great for young couples and families who are likely to need things like maternity cover (including up to three days in a private room) but are less likely to require cardio (heart) procedures or joint replacement surgery. Gold Gold is our award-winning shared-room Hospital cover option. With Gold hospital, you re fully covered for theatre and ward fees. It s especially great if you re planning on having a baby, because our maternity cover includes up to five days in a private room at no extra cost. GoldStar GoldStar is our premium Hospital cover option, with all the bells and whistles. You re fully covered for everything, including a private hospital room, theatre fees and ward fees. No worries. Just total peace of mind for you and your family. Please note: Some waiting periods may apply. See page 22 for full details. Some examples of cardiac (heart) procedures including medical treatment or surgical procedures for cardiac conditions are arrhythmias, artery bypass, grafts, coronary angloplasty, congenital defects, heart disease, stent insertion, heart transplants, pacemakers and defibrillators. AccessGap Cover may apply to reduce your outof-pocket expenses. Please refer to the separate Product Disclosure Statement (PDS) for more details. hif.com.au/pds ^An accident means an unforeseen event occurring by chance and caused by an external force or object which results in injury to the body requiring immediate attention in hospital within 24 hours of the accident.

13 What does our Hospital cover include? Hospital Accomodation Cover GoldVital GoldStarter GoldSaver Gold GoldStar Shared room - all services Private room - all services (co-payment) (co-payment) (co-payment) Private room - (3 days) (5 days) (unlimited) maternity services Services Cover Same-day accommodation Same-day theatre Theatre care Intensive care Appendectomy Removal of tonsils & adenoids Pharmacy drugs (in-patient) Prostheses AccessGap cover Joint reconstruction Minor gynaecological services Hospital charges for surgical removal of wisdom teeth Hospital treatment as the result of an accident^ Palliative care (disease) * (restricted) (restricted) Rehabilitation (restricted) (restricted) Psychiatric care & treatment (restricted) (restricted) (restricted) Ear, nose & throat Back surgery Maternity services Choice of excess Joint replacement Eye surgery (non-cosmetic) Assisted Reproductive Technology (e.g. IVF) Cardiac (heart) (restricted) (restricted) (restricted) (restricted) * Benefits will be paid for Same Day Procedures only for minor gynaecological procedure. ^ An accident means an unforeseen event, occurring by chance and caused by an external force or object which results in an injury to the body requiring immediate medical treatment in hospital within 24 hours of the accident. If further hospital treatment (as an admitted patient) is required, the patient must be re-admitted to a hospital within 90 days of the initial hospital treatment. 13

14 Restrictions Exclusions GoldStar Surgery by Podiatrists Cosmetic services Services not covered by Medicare Gold Surgery by Podiatrists Cosmetic services+ Services not covered by Medicare GoldSaver GoldStarter GoldVital Surgery by Podiatrists Psychiatric Cardio (heart) conditions, procedures or monitoring Eye Surgery Joint Replacement Assisted Reproductive Technology Surgery by Podiatrists Psychiatric Palliative Care Rehabilitation Psychiatric Palliative Care Rehabilitation Cosmetic services+ Services not covered by Medicare Gastric banding and obesity surgery Cosmetic services+ Services not covered by Medicare Gastric banding and obesity surgery Obstetrics (Maternity) Cardio (heart) conditions, procedures or monitoring* Joint Replacement Eye surgery Assisted Reproductive Technology *All services are excluded except for accidents^, tonsils, adenoids, appendix, wisdom teeth surgery, joint reconstruction (not replacements) and investigations or minor gynaelogical procedures only Please note: Some waiting periods may apply. See page 22 for full details. *Some examples of cardiac (heart) procedures including medical treatment or surgical procedures as for cardiac conditions are arrhythmias, artery bypass, grafts, coronary angloplasty, congenital defects, heart disease, stent insertion, heart transplants, pacemakers and defibrillators. +Where a service is deemed by Medicare to be cosmetic or does not attract a Medicare rebate, all charges raised during your hospital stay will not be eligible for payment. A restricted service means a basic public hospital rate will be paid for accommodation and all other charges raised during the stay and out-of-pocket expenses will be paid by the member. O An excluded service means all charges raised during the stay will be paid by the member. Please refer to the separate Product Disclosure Statement (PDS) for more details. hif.com.au/pds ^An accident means an unforeseen event occurring by chance and caused by an external force or object which results in injury to the body requiring immediate attention in hospital within 24 hours of the accident. 14

15 Maternity cover. Whether it s your first baby or your fifth, a new addition to the family is always a magical time. So when it comes to maternity services, our affordable Hospital cover options will give you the peace of mind you deserve. For example... You can choose your own private hospital. You can choose your own obstetrician Your labour ward fees will be fully covered. Your baby will be fully covered on your HIF policy from the moment they re born. We offer three great hospital products that cover maternity services GoldSaver, Gold and GoldStar. What about maternity waiting periods? We know from experience that being pregnant can often result in swollen ankles (not to mention some rather interesting food cravings), but the bundle of joy that arrives nine months later will definitely make the wait worthwhile. And speaking of waiting, the waiting period for all obstetric related services is 1. That means you ll need to have held maternity cover for 1 prior to your estimated due date so remember to take out Hospital cover as early as possible. That way, you ll have already served your hospital waiting periods long before your new bub arrives. Conditions may apply please see our Product Disclosure Statement for more information or restrictions and exclusions. hif.com.au/pds 15

16 Get a quote and join today. Affordable health cover is just a click away To get an instant quote, join at a time that suits you or simply learn more about HIF and our popular range of health cover options, visit hif.com.au Maybe you ve already chosen the Hospital cover, Extras cover or combination you want. Perhaps you re not quite sure and need a bit of advice. Either way, we re here to help you, so get in touch. Online. Visit hif.com.au to use our online product selector (it s easy). You can also get an instant quote and join online. By phone. Call us on and speak to one of our friendly sales consultants. They understand our cover options inside out, so they can help you make a decision and join over the phone. Our call centre is open from 7.00am until 5.30pm (WST), Monday to Friday. By . us at sales@hif.com.au. A member of our team will contact you with all the information and assistance you need to make the right decision and join. You spread the word, we ll share the love One of the reasons we have some of Australia s lowest premiums and best benefits is that our satisfied members spread the word for us. And when they do, we like to say thank you via our Member Rewards Program* you get a $70 gift voucher every time a new member joins us as a result of your recommendation and mentions your name on their application form. *Terms and conditions apply, please visit hif.com.au/members for more information. Don t throw me away It s important that you read and keep this brochure and the accompanying PDS. We ll be testing you to make sure you ve digested all the information... OK, so we won t be testing you, but you really should keep hold of all the information you receive about membership, benefits and conditions. In fact, we re continually improving our benefits, so it s worth downloading the latest version of this brochure and the PDS from time to time. It s the best way to ensure you get the most out of your cover when you need to claim. Visit hif.com.au for the most up-to-date publications. 16 Please note: Your cooling-off period: Once you ve applied for HIF membership, you have 30 days to read your policy. If, during this time, you decide that you don t wish to take up the cover, you may cancel the policy and we will give you a full refund, provided you have not made a claim. Your fund membership will commence on the date your completed application form is lodged with HIF, or a date after the date of lodgement which you have nominated. (The date of lodgement is the date we receive your application.)

17 Switching health funds? We ll take care of it. If you re ready to say goodbye to your old health insurer and hello to better cover, service and premiums with us, it s easy. Just let us know you re switching when you apply for HIF cover and we ll arrange a seamless transfer, pronto. Switching to HIF is easy! To authorise us to arrange the transfer on your behalf, simply check the box during the online application process and enter the name of your previous health fund and your membership number. Alternatively, if you re joining over the phone, you can instruct your Sales Consultant to complete the authorisation details for you. Once we have your authorisation, we ll then contact your previous fund and request that they send us what s known as a Clearance Certificate. The certificate provides HIF with all the details we need in order to finalise your new policy with us, including your length of membership with your old fund, any waiting periods that may still be outstanding, plus any Lifetime Health Cover loading that may apply. Please note that Australian health funds have up to 30 days to issue Clearance Certificates, so if you would like your old fund to issue your certificate as a matter of urgency, please let us know and we can escalate it as a priority request. Alternatively, you can contact your previous fund yourself and submit a direct request for a certificate to be sent to HIF. Waiting periods? What waiting periods? When you become an HIF member, we ll even take your previous membership into account. For example, if you have been with your current fund for 10 years on an equivalent level of cover, we will bring your loyalty across to HIF. And you won t have to re-serve new waiting periods, for any services you were previously covered for. In fact, even if you re switching to a higher level of Extras cover, we will waive all two month waiting periods, so you can claim straight away on popular Extras services like dental, optical, chiro and physio. Call us on or our team at sales@hif.com.au to find out more about switching. Confused about health insurance? Don t be. We know first-hand just how confusing private health insurance can be. But that s why we re here to make everything as simple (and affordable) as possible. So, if you can t find the answer to your questions in this brochure, don t fret. The full need-to-know details of all our Hospital and Extras cover options, plus FAQs and a glossary, can be found in our Product Disclosure Statement booklet or on our website hif.com.au/pds 17

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19 Pay and claim, your way. We re all about choice and making life easy at HIF. Choose the cover that suits you. Choose your hospital, your doctor, your specialist, your dental provider And we also offer a choice of ways to pay your premiums and make a claim, all designed to make life simple. So choose away. Ways to pay Direct debit. Flexible. Automatic. Convenient. No wonder it s our most popular payment option. Manually. We send you an account when your premium is due and you can pay however you like: Phone call for over-the-phone credit card payments (we accept Mastercard, Visa, Diners Club and AMEX). BPAY through your bank s phone or internet banking system. Billpay via your phone or the internet. Online through our online Member Services Centre. In person at any Australia Post branch. By mail post your cheque or money order and the lower half of your invoice to: HIF, GPO Box X2221, Perth WA Ways to claim Electronic Claiming. Healthcare providers with electronic claiming technology (HICAPS or isoft) can settle your account with you on the spot. All you need to do is swipe your HIF membership card and pay the difference (if any). SmartClaim for mobile. If you have an Apple or Android mobile device, you can submit paid Extras accounts of $700 or less by using your mobile s in-built camera to photograph receipts and invoices. Download HIF SmartClaim now from the Apple App Store or the Android Market or see page 21 for more details. Fast-Track Claiming. For paid Extras accounts of $700 or less, try our quick and easy Fast-Track option. Simply scan your completed HIF claim form and associated receipts and invoices, and a copy to claims@hif.com.au. Alternatively, fax a copy to (08) Visit hif.com.au or read our Product Disclosure Statement to find out more about our claiming options. Discounts and special offers Premiums are discounted for members who pay in advance via direct debit or manual invoice: 2% for half-yearly and 4% for yearly. We also operate other special offers throughout the year. Visit hif.com.au to see what s new. Please note: All providers must be registered with HIF for claim benefits to be paid. Benefits will not be paid for any hospital or Extras costs incurred outside Australia or which are not provided as part of a recognised consultation process. Conditions apply for SmartClaim and Fast-Track claims. Please visit hif.com.au or call us on for more details. Upon joining HIF, member cover, benefits and services are subject to our Business Rules. For a copy of the rules, contact us or visit hif.com.au. 19

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